ArticleDiseases (Basel, Switzerland)2025
Impact of Red Pack Cell Transfusion Before or After Endoscopy on Mortality in Patients with Upper Gastrointestinal Bleeding: A Multicenter Cohort Study.
Article in Diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe impact of transfusion timing relative to endoscopy in upper gastrointestinal bleeding (UGIB) remains unclear.
aimTo assess whether transfusion performed before versus after endoscopy affects 30-day mortality in UGIB.
methodsWe conducted a post hoc analysis of a multicenter cohort study including 3324 UGIB patients consecutively admitted in hospital. Propensity score matching adjusted for clinical and procedural variables.
resultsAmong 2017 transfused patients, 34.7% received Red Blood Cells (RBC) before endoscopy. Patients who received transfusions before endoscopy were older, had more severe comorbidities, and presented with a worse physical and hemodynamic status. This study also explored whether transfusion timing relative to endoscopy affects clinical outcomes in patients stratified by baseline hemoglobin levels. While pre-endoscopy transfusion was not significantly associated with reduced 30-day mortality in the overall population, we observed an advantage in patients transfused before the endoscopy when the Hb value was <7 g/dL. Pre-endoscopy transfusion was associated with a 6% absolute reduction in 30-day mortality (
conclusionsIn patients with severe anemia and UGIB, transfusion before endoscopy may reduce mortality. Timing to transfusion should be considered alongside hemodynamic and procedural factors in future guidelines.
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